Thang T S T, Kishen A, Moayedi M et al. The effects of physical photostimulable phosphor plate artifacts on the radiologic interpretation of periapical inflammatory disease. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; DOI: 10.1016/j.oooo.2019.11.001.

….. reduce diagnostic confidence.

Photostimulable phosphor plates (PSP) have the advantages that they are thin, flexible and are available in different sizes. The active surface of the plates is, however, prone to damage from scratching, bites and bending. Damaged plates cause artifacts.

Screens of phosphor plates used on clinic, with varying amounts of damage, were superimposed on 100 anonymised clinical radiographs and reviewed by 25 experienced dentists for evidence of periapical disease. Participants were asked to interpret the radiographic image for possible periapical pathology, score the confidence level of that interpretation and record whether they would discard the PSP on which the radiograph was 'recorded'.

Whilst the interpretation of the radiographs appeared unaffected by the level of damage to the PSP, confidence in the diagnosis decreased with increased damage. Lack of confidence in a diagnosis may lead to further radiographic exposure for the patient and/or a delay in treatment.